摘要
目的评价小剂量氯胺酮对Salter骨盆截骨术患儿舒芬太尼术后镇痛效果的影响。方法择期全麻下行Salter骨盆截骨术患儿90例，年龄3～6岁，随机分为三组。于缝合皮肤时经静脉通路连接镇痛泵，镇痛液配方：S1组（舒芬太尼0．6mg·kg-1·d-1 ＋生理盐水50ml）；S2组（舒芬太尼0．8mg·kg-1·d-1 ＋生理盐水50m1）；KS组（舒芬太尼0．6mg·kg-1·d-1 ＋氯胺酮2．2mg·kg-1·d-1 ＋生理盐水50m1）。记录术后2、4、8、12、24、36h的疼痛VAS评分和Ramsay镇静评分，观察和记录不良反应情况。结果与S1组比较，术后4～36hs2组和KS组VAS评分明显降低（P〈0．05）。术后4～36hS1组Ramsay评分明显低于S2组（P〈0．05）。与S2组比较，S1组和KS组恶心、呕吐、皮肤瘙痒的发生率明显降低（P〈0．05）。结论小剂量氯胺酮可增强Salter骨盆截骨术患儿舒芬太尼术后镇痛效果，且不增加不良反应。
Objective To evaluate the analgesic efficacy of small dose of ketamine on sufentanil postoperative pain relief in children undergoing Salter innominate osteotomy. Methods Ninty children scheduled for elective Salter innominate osteotomy under general anesthesia were enrolled and random- ly allocated into 3 equal groups. Patient controlled intravenous analgesia （PCIA） was started since skin suture with the following composition： sufentanil 0. 6 mg.kg-1 .d-1 in 0.9% NS 50 ml （group S1）, sufentanil 0.8 mg.kg-1 .d-1 in 0. 9% NS 50 ml （group S2）, or sufentanil 0. 6 mg,kg-1 od-1 plus ketamine 2.2 mg.kg-1 -d-1 in 0. 9%NS 50 ml （group KS）. Visual analogue scale （VAS） pain scales and Ramsay sedation scores were recorded at 2, 4, 8, 12, 24, and 36 h after operation, and side effects were observed and recorded. Results VAS value decreased in groups S2 and KS at 4-36 h postoperatively compared with group St （P〈0. 01）. Ramsay score increased significantly in group S2 compared with that of group S1 （P〈0. 05）. Otherwise, the incidence of side effects was significantly decreased in group KS compared with group S2 （P〈0. 05）. Conclusion Small dose of ketamine can improve the sufentanil postoperative analgesic efficacy in children with Salter innominate osteotomy, without increasing the incidence of side effects.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第4期380-382,共3页
Journal of Clinical Anesthesiology
关键词
氯胺酮
舒芬太尼
镇痛
髋脱位
先天性
截骨术
小儿
Ketamine
Sufentanil
Analgesia
Hip dislocation,congenital
Osteotomy
Children
